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Modelling Hepatitis B virus related hospital discharges in Spain: ARIMAX based liver disease forecasting tool for
Lesly Acosta1, Núria Soldevila2,3, Núria Torner2
1Universitat Politècnica de Catalunya· Barcelona Tech, Barcelona, Spain.
Insights
Forecasting chronic hepatitis B (CHB) related cirrhosis and hepatocellular carcinoma (HCC) hospitalizations using ARIMA and ARIMAX models aids disease monitoring and resource allocation. ARIMAX models offer more accurate predictions for public health decisions.
Area of Science:
- Epidemiology
- Time Series Analysis
- Public Health
Background:
- Chronic hepatitis B (CHB) infection is a significant cause of cirrhosis and hepatocellular carcinoma (HCC).
- Accurate forecasting of CHB-related hospitalizations is crucial for healthcare planning and intervention assessment.
Purpose of the Study:
- To develop and evaluate ARIMA-based models for forecasting global hospital discharges related to CHB-induced cirrhosis and HCC.
- To compare the predictive accuracy of seasonal ARIMA and ARIMAX models.
Main Methods:
- Retrospective observational study of monthly CHB hospitalization data in Spain (2005-2021).
- Utilized Spanish Minimum dataset of hospital discharge registry (CMBDH) with ICD codes for CHB, cirrhosis, and HCC.
- Employed seasonal ARIMA and ARIMAX models, with data transformation for stationarity and model selection based on AIC, BIC, and MAPE.
Main Results:
- A total of 6743 discharges were analyzed; 58% were HCC-related and 42% cirrhosis-related.
- The best-fit model for CHB and HCC time series forecasting was an approximate Gaussian [Formula: see text]-ARIMAX (6,0,0) (0,1,1)_12 model.
- The model effectively handled outliers, removed seasonal patterns, and captured autoregressive dynamics.
Conclusions:
- ARIMA and ARIMAX models are vital for forecasting CHB-related cirrhosis and HCC, improving disease surveillance and resource management.
- ARIMAX models provide more accurate, context-aware predictions, supporting informed public health decision-making.
Introduction:
Chronic hepatitis B (CHB) virus infection leads to severe complications, cirrhosis and hepatocellular carcinoma (HCC). The main objective of this study was to develop an ARIMA-based model to forecast the progression of global hospital discharges, due to cirrhosis and HCC related to chronic hepatitis B.
Methods:
Retrospective observational study of monthly incidence of CHB related hospitalization discharges from 2005 to 2021 in Spain. Data were obtained through the Spanish Minimum dataset of hospital discharge registry (CMBDH) of the Health Ministry. Main diagnosis of CHB, liver cirrhosis and HCC encoded by International Medical codes (ICM-9 and ICM-10) were used. Descriptive and time series analysis was performed with forecasts made for 2022 using seasonal ARIMA and ARIMAX models. Data stationarity was achieved via a square root Box-Cox transformations and differencing. Model selection used was AIC, BIC, MAPE, and forecasting precision. Analysis was performed in R (version 4.5.0).
Results:
The total number of discharges related to hepatitis B was 6743, 58% were due to HCC and 42% to cirrhosis diagnosis. Median age was 59 years (range: 7 to > 100), being 83.4% men. The global chronic hepatitis B (CHB) related workload values range from 10 to 55 monthly discharges, while hepatitis B related to HCC and cirrhosis range from 4 to 34 and 1-29 discharges, respectively. The best fit and 2022 forecasts found for CHB and HCC time series was obtained with the approximate Gaussian [Formula: see text]-ARIMAX (6,0,0) (0,1,1) _12 model. This model after treating outliers, removes seasonal patterns and captures the series' autoregressive dynamics with an AR(6) and seasonal MA(1) noise with expression: [Formula: see text] with ε ~ N(0, σ²) and in the square root scale.
Conclusion:
Both ARIMA and ARIMAX models play critical roles in forecasting CHB-related HCC and cirrhosis, enabling better disease monitoring, healthcare resources, and intervention assessment. ARIMAX provided more accurate context-aware predictions, making it especially valuable for public health decision-making.
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